This question comes up with some regularity, so I thought I’d finally post a response here on the Wheat Belly Blog. It doesn’t help that general surgeons who perform cholecystectomies are among the most desperately ignorant on diet and health and commonly tell their patients that, after removing the gallbladder, they must adhere to a low-fat diet—yes, the diet that pushes you closer to type 2 diabetes, contributes to high triglyceride levels and fatty liver, heart disease, dementia and other health problems.
So can you include plenty of fats and oils in your diet after you’ve lost your gallbladder? Yes, you can absolutely. But there are several things to know.
First of all, with the gallbladder removed, your liver still manufactures plenty of bile that trickles out into the duodenum. The only difference is that you can no longer store up a repository of bile in the gallbladder to release all at once (an effect, by the way, blocked by wheat germ agglutinin in wheat, rye, barley, and rice because this indigestible protein blocks cholecystokinin, the hormone that causes the gallbladder to squeeze out its bile—this is why grain-eaters have more gallstones). So it is conceivable that, should you consume a bunch of fats and oils all at once, you could overwhelm the trickle of bile from the liver, but this rarely happens. The great majority of people are able to consume butter, olive oil, coconut oil, etc. without problems.
Some people think that they have problems with fats and oils but what they typically often really have is dysbiosis and small intestinal bacterial overgrowth, SIBO, that is highly prevalent in people with diseased gallbladders. After all, if you created gallstones in your gallbladder, you have suffered decades of gastrointestinal disruption and inflammation. Disrupted bowel flora is virtually guaranteed. Dysbiosis and SIBO can be responsible for all manner of peculiar gastrointestinal and other symptoms that are often misinterpreted as fat intolerance. So key is to adopt ALL the Wheat Belly strategies to cultivate healthy bowel flora (fully articulated in the Wheat Belly Total Health, Wheat Belly 10-Day Grain Detox, and Undoctored books).
I can count on three fingers the number of people I’ve encountered over the years who needed to supplement bile acids and pancreatic enzymes to compensate for the loss of a gallbladder—it does happen, but it is distinctly uncommon. If you take such supplements because you assumed that you would need to, you can begin to titrate them down to gauge need, provided you have already taken steps to cultivate bowel flora.
If you are just starting out on your Wheat Belly or Undoctored lifestyles and are a bit nervous about your tolerance to fats and oils, you can always build up over time, increasing your intake to gauge your response. But I predict that the vast majority of you without gallbladders will do just fine.